PATIENT AND SURGEON SATISFACTION IN SMALL INCISION CATARACT SURGERY USING TOPICAL AND PERIBULBAR ANAESTHESIA IN A TERTIARY CARE HOSPITAL

Abstract

Mohd. Ayaz Bhat1, Ambrine Ashraf2, Mahrukh3, Ashok Sharma4

INTRODUCTION
Patient and surgeon satisfaction with topical versus peribulbar anaesthesia have been documented by various studies and has been a conflicting argument. In this study, we assessed in terms of patient’s pain and surgeon satisfaction using these two anaesthetic techniques for better outcome of cataract surgeries.
AIM
To evaluate efficacy in terms of pain, visual outcome and surgeon satisfaction with topical anaesthesia versus peribulbar anaesthesia in Small Incision Cataract Surgery (SICS).
MATERIALS & METHODS
A prospective clinical study was conducted at Government Medical College (GMC) Jammu from November 2010 to October 2011. A total of 300 patients underwent SICS with 150 patients in each group receiving topical & peribulbar anaesthesia respectively. Patient’s pain during application of anaesthesia and during surgery were assessed by visual analogue pain scale. Surgeon satisfaction in terms of intraoperative difficulty was evaluated. The student’s t-test and chi square test was used to determine IOWA score in both groups. p ??0.05 was considered significant.
RESULTS
Feeling of pain during the administration of topical anaesthesia was significantly lower as compared to peribulbar anaesthesia (p ??0.005). While there is not much difference in pain during surgery in both the groups (p=0.026, not significant). Regarding visual acuity, there is significant difference between the two groups on I st postoperative day (p=0.005), while there was no difference between the two groups at the 6th week (p=0.85). There was no significant intraoperative difficulty encountered by the surgeon in both the groups.
CONCLUSION
Topical anaesthesia is preferable to peribulbar anaesthesia and is recommended as a safe and effective alternative to peribulbar anaesthesia for cataract surgery.

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